Did Meaningful Use Really Turn EMRs Into A Commodity?

Not long ago, I had a nice email exchange with a sales manager with one of the top ambulatory EMR vendors.  He had written to comment on “The EMR Vendor’s Dilemma,” a piece I wrote about the difficult choices such vendors face in staying just slightly ahead of the market.

In our correspondence, he argued that Meaningful Use (MU) had led customers to see EMRs as commodities. I think he meant that MU sucked the innovation out of EMR development.

After reflecting on his comments, I realized that I didn’t quite agree that EMRs had become a commodity item. Though the MU program obviously relied on the use of commoditized, certified EMR technology, I’d argue that the industry has simply grown around that obstacle.

If anything, I’d argue that MU has actually sparked greater innovation in EMR development. Follow me for a minute here.

Consider the early stages of the EMR market. At the outset, say, in the 50s, there were a few innovators who figured out that medical processes could be automated, and built out versions of their ideas. However, there was essentially no market for such systems, so those who developed them had no incentive to keep reinventing them.

Over time, a few select healthcare providers developed platforms which had the general outline EMRs would later have, and vendors like Epic began selling packaged EMR systems. These emerging systems began to leverage powerful databases and connect with increasingly powerful front-end systems available to clinicians. The design for overall EMR architecture was still up for grabs, but some consensus was building on what its core was.

Eventually, the feds decided that it was time for mass EMR adoption, the Meaningful Use program came along. MU certification set some baselines standards for EMR vendors, leaving little practical debate as to what an EMR’s working parts were. Sure, at least at first, these requirements bled a lot of experimentation out of the market, and certainly discouraged wide-ranging innovation to a degree. But it also set the stage for an explosion of ideas.

Because the truth is, having a dull, standardized baseline that defines a product can be liberating. Having a basic outline to work with frees up energy and resources for use in innovating at the edges. Who wants to keep figuring out what the product is? There’s far more upside in, say, creating modules that help providers tackle their unique problems.

In other words, while commoditization solves one (less interesting) set of problems, it also lets vendors focus on the high-level solutions that arguably have the most potential to help providers.

That’s certainly been the case when an industry agrees on a technology specification set such as, say, the 802.11 and 802.11x standards for wireless LANs. I doubt Wi-Fi tech would be ubiquitous today if the IEEE hadn’t codified these standards. Yes, working from technical specs is different than building complex systems to meet multi-layered requirements, but I’d argue that the principle still stands.

All told, I think the feds did EMR vendors a favor when they created Meaningful Use EMR certification standards. I doubt the vendors could have found common ground any other way.

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

1 Comment

  • Respectfully…but you HAVE to be kidding me…MU and CertEHR has set back REAL innovation in EHRs at LEAST a decade. There is no metphorical wireless standard out there that is connecting all EHRs. The artificial market for EHRs drove companies to make crappy software that fits the clicks of the Cert. ALL resources were put into these one size fits none disasters. There has been almost ZERO innovation. Its ONLY getting worse! Every year ONC/CMS adds even more complicated ridiculousness to the Cert requirements that again distract vendors from REAL innovation and working with front line MDs. There is NO room for innovation and you risk decertification if you do ANY outside the box thinking, changes, customization, etc. The market was going in the right direction, then some arrogant, nonclinical, nonEHR experienced people started scribbling untested, incomplete, meaningless buzzword cert requirements that did nothing but further complicate the situation. All current EHRs are basically billing tools with a crappy clinical layer tacked on top. No database rookie would have even MENTIONED interoperability without a primary key (unique ID) for each patient, right then and there, they should have turned right back to Congress and say we can’t do it without a unique ID for each person in the US. All these counting numerators, denominators, highly technical fuzzy MU cert EHR reporting requirements, with attesting auditing etc made the nightmare extreme. Popup boxes, clicking here there and everywhere, do this before that, but not this and dont forget this has devastated the practice of medicine. Wake up. Cert EHR, MU has been a COMPLETE failure and has damaged the medical profession beyond repair.

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